Secondary epispadias repair with rectus abdominis musculocutaneous flap

Genital defects in patients with epispadias cause functional, aesthetic, an d psychological problems. Successful reconstruction of epispadias should im prove the body image and enable the patient to perform sexually. Although v arious operative techniques have been defined for reconstruction of epispad ias-predominantly using local tissue flaps-classic reconstructive methods a re sometimes not sufficient in severe cases. Secondary reconstruction is in evitable after failed reconstructive attempts with classic techniques. The authors used the rectus abdominis musculocutaneous flap for severe secondar y epispadias repair. The urethra, dorsal chordee, osteo-escutcheon contour defect, and the tissue defect created after dissection of the dorsal surfac e of the penis were reconstructed successfully using the rectus abdominis m usculocutaneous flap. The neourethra was constructed using the skin island of the flap, and the muscle segment was used to reconstruct the dorsal defe cts. A straightened and lengthened penis and a new urethra without strictur e were created during one operative procedure using this method.